JP4557938B2 - Intraocular lens insertion device - Google Patents

Description

The present invention relates to an intraocular lens insertion device used for inserting an intraocular lens into the eye.

  Conventionally, in surgery such as cataract, the lens in the capsule is removed and removed through an incision made in the eye tissue such as the cornea (capsular membrane) or the anterior lens capsule. The technique of inserting into the eye through the incision and placing it in the sac is employed.

  In particular, in recent years, a technique using an intraocular lens insertion device as described in Patent Document 1 and Patent Document 2 has been widely adopted. With such an insertion device, it is possible to insert an intraocular lens without expanding the incision formed for the removal of the crystalline lens, so that the labor required for the operation can be reduced, as well as the occurrence of postoperative astigmatism and infection. Risk can also be reduced.

  By the way, as disclosed in Patent Document 1 and Patent Document 2, many conventional insertion instruments include a holding member having a hinge portion that can be opened and closed. In such an insertion device, after placing the intraocular lens on the open hinge portion, the intraocular lens is sandwiched by closing the hinge portion and holding the intraocular lens in an initial deformation state. Has been.

  However, such an insertion instrument has a problem that it is difficult to place the intraocular lens because the intraocular lens must be placed on the hinge that opens and closes. In addition, the insertion instrument as described in Patent Document 1 has a problem that it is difficult to adjust the opening / closing strength of the hinge part because the hinge part is formed integrally with the instrument body. It was. In addition, as described in Patent Document 2, it is conceivable to adjust the opening / closing strength by making the holding member and the instrument body separate from each other and making the material of the holding member different from the instrument body. This is not a preferable measure because it increases the number of parts.

  Furthermore, in these insertion devices, if the hand is released from the hinge part, the hinge part may open and the intraocular lens may fall off. Therefore, after closing the hinge part, release the hand from the holding member. There was also a problem of being unable to. Therefore, in these insertion devices, a separate operation such as fixing the hinge portion in a closed state using a holding member such as a sleeve is necessary.

  In addition, in the process of closing the hinge portion and sandwiching the intraocular lens from both sides, the intraocular lens may be initially deformed into an unexpected shape due to a slight change in the position of the intraocular lens. There was also. If the initial deformation of the intraocular lens is not performed correctly, the subsequent intraocular lens cannot be pushed out smoothly, and in some cases, excessive force is applied to the intraocular lens, which may damage the intraocular lens. There was also.

Japanese Patent No. 3412103 Special Table 2002-52523

  Here, the present invention has been made in the background as described above, and the problem to be solved is that the intraocular lens can be accommodated with excellent operability and the desired initial deformation can be stabilized. It is an object of the present invention to provide an insertion device for an intraocular lens having a novel structure that can be expressed in the above manner.

  Hereinafter, embodiments of the present invention made to solve the above-described problems will be described. In addition, the component employ | adopted in each aspect as described below is employable by arbitrary combinations as much as possible.

  That is, the present invention deforms the intraocular lens accommodated in the instrument body having a substantially cylindrical shape by small deformation while moving it forward in the axial direction by the pushing member inserted from the rear in the axial direction into the instrument body. In an insertion device for an intraocular lens that is inserted into the eye by being pushed out through an insertion tube provided at an axial tip portion of the device body, the eye is opened upward at a substantially central portion in the axial direction of the device body. A stage having a substantially flat placement surface on which the inner lens is placed is formed, and at the center in the width direction of the placement surface, it extends in the axial direction of the instrument body and opens upward. While a concave groove is formed and communicated with the insertion tube portion, it is superimposed on the stage to cover the opening of the stage, and above the intraocular lens placed on the placement surface. Pressed from It is further comprising a lid member having a pressing projection is pushed by the deformed state ocular within the lens the concave-shaped groove by, characterized.

  In the intraocular lens insertion device having a structure according to the present invention, the intraocular lens is placed on a stage having a flat placement surface, so that it can be opened and closed like a conventional hinge structure. It can be placed more easily than a structure in which an intraocular lens is placed. Moreover, since the opening part of a stage is covered with a cover member after accommodating in an insertion instrument, the possibility of drop-off can be effectively prevented, and the handleability is also improved.

  In the intraocular lens insertion device according to the present invention, the pressing protrusion for deforming the intraocular lens is pressed from above the intraocular lens. As a result, it is possible to effectively reduce the risk of rotating the intraocular lens inside the insertion device due to the pressing protrusion being pressed against the intraocular lens from an oblique direction, and the initial deformation of the intraocular lens. Can be expressed stably. Furthermore, in the intraocular lens insertion device according to the present invention, since the intraocular lens can be stably placed on the stage, the displacement of the initial position during housing can be reduced, and the desired initial deformation can be achieved. It can be expressed more stably.

  Further, in the intraocular lens insertion device according to the present invention, it is preferable that the lid member is connected to the device main body by a flexible first connecting portion and is integrally formed with the device main body. Can be adopted. If it does in this way, it will become unnecessary to manage a lid member separately from an instrument main part, and handling nature can be improved more.

  In the intraocular lens insertion device according to the present invention, the pressing member having the pressing protrusion is connected to the lid main body portion of the lid member by a flexible second connecting portion, and the lid main body portion. On the other hand, the lid main body portion is provided with guide means for guiding the pressing projection from above the intraocular lens placed on the mounting surface to the intraocular lens. The aspect which is mentioned can be employ | adopted suitably.

  By doing so, it is possible to apply initial deformation to the intraocular lens in a state where the stage is previously covered with the lid member. Thus, when the intraocular lens is deformed, the intraocular lens can be initially deformed while more effectively preventing the intraocular lens from jumping out of the insertion device. In addition, since the pressing member is formed integrally with the lid main body portion, it is not necessary to manage the pressing member separately, and excellent handleability can be obtained.

  In the intraocular lens insertion device according to the present invention, it is preferable that the lid main body portion is provided with a holding unit that holds the pressing protrusion in a state of pressing the pressing protrusion against the intraocular lens. Can be done.

  If it does in this way, it can prevent that a pressing protrusion part remove | deviates from a lid | cover main-body part easily. Thus, the intraocular lens can be pushed out in the insertion device while the initial deformation state of the intraocular lens is stably maintained. The specific mode of the holding means is not particularly limited, for example, by providing a slit through which the pressing protrusion is inserted in the lid main body, and holding the pressing protrusion with the wall surface of the slit, An engagement portion that engages and fixes each other may be provided on the lid main body portion and the pressing member.

  In the intraocular lens insertion device according to the present invention, a mode in which the pressing member is connected to the lid main body portion in substantially the same direction as the axial direction of the device main body can be suitably employed. If it does in this way, the arrangement direction of a lid body part and a pressing member can be made into the same direction as the extension direction of an instrument main part, and the width direction size of the insertion instrument of an intraocular lens can be made compact. .

  Moreover, in the intraocular lens insertion device according to the present invention, the pressing projection is formed with a dimension extending over the optical part and the support part of the intraocular lens placed on the placement surface. Can be suitably employed. In this way, a pressing force can be exerted over almost the entire intraocular lens, so that an excessive pressing force is locally applied to the intraocular lens to reduce the risk of damage. At the same time, the intraocular lens can be stably deformed.

  In the intraocular lens insertion device according to the present invention, the distal end portion of the pushing member is formed with a substantially semicircular cross-sectional shape having a flat surface, and the distal end portion faces the flat surface upward. A mode in which it is positioned and can be displaced below the pressing protrusion in the concave groove can be suitably employed.

  If it does in this way, when displacing an extrusion member in a concave groove, the tip part of an extrusion member and a pressing projection can be made non-contact. Thereby, an extrusion member can be pushed in without being obstructed by a pressing projection. It is also possible to avoid the situation where the initial deformation state of the intraocular lens is not maintained due to the pressing projection being displaced by the pushing member. Accordingly, it is possible to push out the intraocular lens while effectively maintaining the initial deformation state by the pressing protrusion.

  In the intraocular lens insertion device according to the present invention, the push-out member is provided with a push-out guide portion that guides the push member pressed against the intraocular lens in a direction away from the intraocular lens. The aspect which exists can be employ | adopted suitably.

  In this way, the pressing member can be removed from the concave groove when the intraocular lens is pushed out. Thereby, an extrusion member can be formed more thickly and a bending etc. of an extrusion member can be prevented. In addition, this aspect can be employ | adopted more suitably by combining with the front-end | tip part which has the cross-sectional shape of substantially semicircle as mentioned above. For example, it is preferable to provide an extrusion guide portion behind the tip portion. In this way, it is possible to prevent the pushing member from being bent while effectively maintaining the initial deformation state of the intraocular lens.

  Hereinafter, in order to clarify the present invention more specifically, embodiments of the present invention will be described in detail with reference to the drawings.

  First, FIG. 1 shows an intraocular lens insertion device 10 as one embodiment of the present invention. The insertion instrument 10 is configured by inserting a plunger 14 into an instrument main body 12 having a substantially cylindrical shape with the inside penetrated over the entire length and the front and rear end edges opened. In the following description, “front” refers to the extending direction of the insertion instrument 10 (left side in FIG. 1), and “upper” refers to the upward direction in FIG. Moreover, the left-right direction means the left-right direction in the back view of the insertion instrument 10 (in FIG. 1, the diagonally downward direction is left and the diagonally upward direction is right).

  The instrument main body 12 has a main body cylinder portion 16 having a substantially cylindrical shape, and a rectangular plate extending in a direction orthogonal to the extending direction of the main body cylinder portion 16 at the rear end portion of the main body cylinder portion 16. The shape portion 18 is integrally formed.

  On the other hand, a nozzle portion 20 as an insertion tube portion is integrally formed at the distal end portion of the instrument body 12. As shown in FIGS. 2 and 3, the nozzle portion 20 is formed with an outer shape that gradually tapers from the proximal end portion on the instrument body 12 side to the distal end portion in the extending direction. And the through-hole 22 penetrated over the full length of the extending direction is formed in the nozzle part 20. As shown in FIG. 3, the through-hole 22 has a substantially rectangular opening shape at a proximal end opening 23 (cross section AA in FIG. 3) on the proximal end side, and a distal end opening 24 ( In FIG. 3, it is gradually deformed into a substantially elliptical shape as it goes to the section JJ.

  More specifically, the through hole 22 has upper and lower flat surfaces 25 and 26 as flat portions extending substantially parallel in the width direction on both upper and lower surfaces on the base end opening 23 side. The left and right wall surfaces 28 and 30 as the left and right surfaces extending substantially parallel to the upper and lower directions are connected to both the left and right sides of the two ends, respectively, thereby forming a substantially rectangular opening shape. And the extension dimension of the width direction of the up-and-down flat surfaces 25 and 26 is gradually made small as it goes to the front-end | tip opening part 24. FIG. At the same time, the left and right wall surfaces 28 and 30 are gradually curved outwardly to have a reduced height dimension, and have a substantially arc shape on the tip opening 24 side.

  As a result, as shown in FIG. 4 as a model, the through-hole 22 is gradually reduced in cross-sectional area by the upper flat surface 25 being brought closer to the lower flat surface 26 as it goes to the front end side. The opening 24 is opened with a substantially elliptical shape. In particular, in the present embodiment, the upper flat surface 25 has an arc shape with a substantially constant curvature that protrudes inward over the entire length of the through hole 22 in the cross section in the extending direction of the through hole 22. .

  Further, in the insertion instrument 10 according to the present embodiment, the upper and lower flat surfaces 25 and 26 are formed on the upper and lower surfaces of the through hole 22, so that the entire length of the nozzle portion 20 is parallel to the central axis of the instrument body 12. A flat surface extending in the direction is formed. At the same time, a corner chamfered curved surface is formed over the entire length of the through hole 22 at the connecting portion between the upper and lower flat surfaces 25 and 26 and the left and right wall surfaces 28 and 30. The wall surfaces 28 and 30 are connected smoothly. Then, as the height dimension of the through hole 22 is reduced, the curved surfaces formed at the upper and lower ends are connected to each other so as to form one substantially arc shape on the tip side. The tip portion of the nozzle portion 20 is cut in an oblique direction and has a sharp upper portion so that it can be easily inserted into the eye.

  In addition, a placement portion 34 as a stage on which the intraocular lens 32 is placed is provided between the nozzle portion 20 and the body cylinder portion 16 in the instrument body 12. As shown in a model in FIG. 5, the mounting portion 34 has a groove shape extending in the axial direction with the opening portion 36 opened upward as a whole, and the width dimension of the opening portion 36 is the intraocular shape. The diameter of the optical part 38 of the lens 32 is slightly larger. Then, stepped portions 40, 40 that are projected from both ends in the width direction toward the central axis of the instrument body 12 are formed on the facing surface in the width direction slightly below the opening 36 in the mounting portion 34. As a result, the upper surfaces of the stepped portions 40 and 40 become substantially flat mounting surfaces 41 and 41, and a substantially U-shape opened upward between the widthwise facing surfaces of the stepped portions 40 and 40. A plunger insertion hole 42 is formed as a concave groove extending on the central axis of the instrument body 12 with a cross section. The plunger insertion hole 42 is communicated with the through hole 22 by connecting the bottom surface of the tip of the plunger insertion hole 42 to the lower flat surface 26 of the through hole 22 in the nozzle unit 20.

  Further, a cover portion 44 as a lid body portion is formed on the side of the placement portion 34 in the instrument body 12 (on the right side in the present embodiment). The cover part 44 has a dimension that covers the entire mounting part 34, that is, a width dimension substantially equal to the width dimension of the instrument body 12 and an axial direction that is slightly larger than the maximum width dimension including the support parts 46 and 46 of the intraocular lens 32. It is formed integrally with the instrument body 12 with a length dimension. The cover portion 44 is formed with a predetermined thickness dimension, and the central portion in the width direction has the same orientation as the axial direction of the instrument body 12 over substantially the entire front and rear width direction of the cover portion 44. An extending slit-like guide hole 48 is formed through the cover portion 44 in the thickness direction.

  And the cover part 44 and the instrument main body 12 are connected by the cover connection part 50 formed by the outer edge part of the opening part 36 in the mounting part 34 extending outward in the width direction. The cover connecting portion 50 is formed so thin that the cover portion 44 can be easily bent toward the main body cylinder portion 12, and the cover connecting portion 50 constitutes a flexible first connecting portion. Yes.

  Note that an engaging piece 52 is integrally formed on the outer edge of the cover portion 44 in the width direction. On the other hand, a protruding edge 54 that slightly protrudes outward in the width direction is formed on the outer edge of the opening 36 opposite to the cover connecting portion 50. Engagement notches 56 are formed at corresponding positions.

  A pressing plate member 58 as a pressing member is connected to the rear end portion of the cover portion 44 by a pressing plate connecting portion 60. The pressing plate member 58 is integrally formed with a substantially rectangular plate-shaped pedestal portion 62 having a plane size slightly smaller than the cover portion 44 and a protruding plate portion 64 as a pressing protrusion protruding from the pedestal portion 62. It is structured. The protruding plate portion 64 is a plate shape that extends at the center in the width direction of the pedestal portion 62 in the same direction as the axial direction of the instrument body 12 and has a length dimension that reaches the optical portion 38 and the support portions 46 and 46 of the intraocular lens 32. It is said that. The protruding dimension of the protruding plate part 64 is larger than the thickness dimension of the cover part 44. Moreover, the protrusion front-end | tip part of the protrusion board part 64 is made into the smooth curved surface which becomes convex in a protrusion direction.

  The pressing plate member 58 is connected to the cover portion 44 by the pressing plate connecting portion 60. In the present embodiment, the cover member 44 includes the cover portion 44 and the pressing plate member 58. And in this embodiment, the cover part 44, the pressing board member 58, and the pressing board connection part 60 which connects these are integrally molded with the instrument main body 12, and the site | part which connects the cover part 44 and the pressing board member 58 is formed. The pressing plate connecting portion 60 is formed by being formed with a thin plate shape. Accordingly, the pressing plate connecting portion 60 is configured such that the pressing plate member 58 is flexible enough to be easily bent to the cover portion 44 side. The 2nd connection part is comprised. Furthermore, in this embodiment, the pressing plate connecting portion 60 is formed to extend from the rear end edge portion of the cover portion 44 in the same direction as the axial direction of the instrument main body 12, and the cover portion 44 and the pressing plate member 58 are formed. However, by being arranged in the same direction as the axial direction of the instrument body 12, the width dimension of the insertion instrument 10 is kept small.

  In particular, in the present embodiment, the opening portion 36, the stepped portions 40 and 40, and the plunger insertion hole 42 of the mounting portion 34 extend from the rear of the mounting portion 34 to the distal end portion of the main body cylindrical portion 16. It extends with a substantially constant cross-sectional shape. A molding lid 66 is integrally formed on the outer edge of the opening 36 on the side opposite to the cover 44 at the rearward extension portion of the mounting portion 34. Similar to the cover connecting portion 50, the forming lid 66 is integrally connected to the instrument body 12 by a thin lid forming portion 68 that is easily bent and is formed at the extended portion of the opening 36. It can be opened and closed. Also, in the molding lid portion 68, similarly to the cover portion 44, an engagement piece 70 is formed to project at the outer edge, and the engagement piece 70 is formed at the extended portion of the opening 36. It is engaged with an engaging notch 74 formed on a protruding edge 72 that protrudes outwardly on the opposite side of the molding lid coupling portion 68, and is maintained in a closed state. The molding lid 66 is formed to facilitate the molding of the instrument body 12 and is not always necessary. When the molding lid 66 is omitted, the main body cylinder portion 16 is omitted. Is formed to extend forward until it reaches the rear side of the mounting portion 34.

  As described above, the instrument main body 12 in the present embodiment is configured as a single member by integrally molding the main body cylinder portion 16, the cover portion 44, the pressing plate member 58, and the placement portion 34. Note that the instrument main body 12 is formed of a transparent member having optical transparency, and the mounting portion is passed through the cover portion 44 and the pressing plate member 58 even when the mounting portion 34 is covered with the cover member 44. The intraocular lens 38 placed on 34 is visible.

  And the plunger 14 as an extrusion member is inserted from the back of the instrument main body 12 having such a structure, and is inserted through the plunger insertion hole 42. The plunger 14 is a substantially rod-shaped member having a length dimension slightly larger than the length dimension of the main body cylinder portion 12, and the front side portion from the substantially central portion in the longitudinal direction serves as the action portion 76, while the rear portion The side portion is a guide portion 78, and the rear end edge portion is an integrally molded product in which a plate-like rear end plate portion 80 extending in a direction perpendicular to the axis is formed.

  As shown in FIG. 5A, the action portion 76 is formed with a width dimension that allows the action portion 76 to be inserted into the plunger insertion hole 42 with a predetermined gap, and the distal end portion 82 extends to the plunger insertion hole 42. In the inserted state, a semicircular cross-sectional shape having a flat portion 83 formed on the side positioned on the upper side and a constant cross-sectional shape over a predetermined dimension in the axial direction are formed. As shown in FIG. 6, an inclined portion 84 is formed on the rear side of the tip portion 82 as an extrusion guide portion whose height dimension is gradually increased toward the rear. The rear part extends from the axial direction with a substantially constant cross-sectional shape. As a result, the action portion 76 of the plunger 14 extends from the tip edge portion toward the rear at the tip portion 82 with a substantially constant semicircular cross-sectional shape, and then gradually increases in height and becomes thicker at the inclined portion 84. Thus, it extends from the rear edge of the inclined portion 84 with a substantially constant cross-sectional shape.

  On the other hand, a guide part 78 is formed behind the action part 76. The guide part 78 is formed to extend in the axial direction with a substantially constant rectangular outer shape that is thicker than the action part 76. Further, the guide portion 78 is formed with a concave guide groove 86 that opens upward and extends substantially in the entire axial direction of the guide portion 78.

  The plunger 14 having such a structure is inserted from the rear side of the instrument main body 12, and the action portion 76 is inserted into the plunger insertion hole 42 of the instrument main body 12. Here, the rear end opening shape of the instrument main body 12 is a substantially rectangular shape corresponding to the outer shape of the guide portion 78, thereby preventing the plunger 14 from rotating relative to the instrument main body 12.

  Here, a lock portion 88 is integrally formed at the rear end portion of the instrument body 12. The lock portion 88 includes an opening 90 that opens above the instrument body 12 and communicates with the inside, and an engagement lid portion 92 that opens and closes the opening 90. The engagement lid portion 92 has a substantially plate shape and is integrally formed with the instrument main body 12, and the connection portion with the instrument main body 12 is formed so as to be thinly deformable like the cover coupling portion 50, thereby opening 90. Can be opened and closed. Further, an engagement piece 94 that is substantially the same as the cover portion 44 is formed at the end of the engagement lid portion 92, and the engagement piece 94 is an edge of the opening 90 opposite to the engagement lid portion 92. The engagement lid portion 92 is maintained in a closed state by being engaged with an engagement notch 96 formed in the portion.

  The engaging lid 92 is formed with a locking protrusion 100 that protrudes to the inside of the instrument body 10 in the closed state. The locking projection 100 is formed to extend in the axial direction of the instrument body 10 with a width dimension slightly smaller than the width dimension of the guide groove 86, and in the guide groove 86 in the closed state of the engagement lid portion 92. It is arranged.

  Here, as schematically shown in FIG. 7, the locking projection 100 is formed with a wall surface extending in the vertical direction on the front end surface and an inclined surface inclined upward from the front end surface toward the rear. Has been. On the other hand, a plurality of claw portions 102 are formed side by side on the bottom surface of the guide groove 86 near the front end portion over a predetermined range. The nail | claw parts 102 and 102 are made into the shape which inclines below gradually as it goes to the front from a rear end surface while a rear-end surface is made into the wall surface extended vertically upwards. As a result, the claw portions 102 and 102 have their rear end surfaces locked to the front end surface of the locking projection 100 to prevent relative displacement in the rearward direction with respect to the locking projection 100, while allowing relative displacement in the forward direction. In addition, when the claw portion 102 is locked to the locking protrusion 100, a pull-out prevention mechanism that prevents displacement of the plunger 14 in the pull-out direction with respect to the instrument main body 12 is configured. On the other hand, when the plunger 14 is pushed out, it is used as a moderation mechanism that allows the plunger 14 to be pushed out with moderation by sequentially engaging a plurality of claws 102, 102 with the locking projection 100. It is like that. Thus, in this embodiment, the advance / retreat prevention mechanism of the plunger 14 is comprised including the latching protrusion 100 in the lock part 88, and the nail | claw parts 102 and 102 in the guide groove 86. FIG. In addition, in FIG. 1, although the state which the latching cover part 92 was opened in order to make an understanding easy is shown in figure, as it is clear also from the latching protrusion 100 being used as a moderation mechanism, In the present embodiment, the locking lid portion 92 is used in a closed state even when the plunger 14 is pushed.

  The initial position of the plunger 14 with respect to the instrument body 12 is set by the engagement of the locking projection 100 and the claw portion 102. In particular, in the present embodiment, the tip edge of the plunger 14 is A position (position shown in FIG. 1) positioned slightly behind the optical unit 38 of the intraocular lens 32 placed on the placement unit 34 is set as an initial position.

  In the insertion device 10 having such a structure, first, the molding lid 66 and the engagement lid 92 are closed, and the plunger 14 is positioned at the initial position (the position shown in FIG. 1 described above). In this state, the intraocular lens 32 is placed on the placement surfaces 41 and 41 of the placement unit 34. Here, a positioning protrusion 104 protruding upward is formed in front of the mounting surface 41 formed on the cover portion 44 side, and the intraocular lens 32 is formed at the rear end edge of the positioning protrusion 104. The intraocular lens 32 is positioned in the mounting portion 34 by abutting the edge portion of the optical portion 38.

  Then, by bending the cover connecting portion 50, as shown in FIG. 8, the cover portion 44 is overlapped with the opening portion 36 of the placement portion 34, and the opening portion 36 is covered with the cover portion 44. As a result, the opening 36 is covered by the cover 44 and the molding lid 66 over substantially the entire axial direction. In addition, the cover part 44 is hold | maintained by the engagement piece 52 of the cover part 44 being engaged with the notch 56 for engagement.

  Here, projecting walls 106 and 108 that protrude slightly upward and extend over a predetermined axial dimension are formed at the upper edge of the opening 36. The outer side surfaces of the guide wall portions 110 and 110 formed on both sides in the width direction of the guide hole 48 in the cover portion 44 are brought into contact with the inner side surfaces of the protruding wall portions 106 and 108, whereby the cover portion 44 is The guide hole 48 is positioned so as to be located at the center of the mounting portion 34 in the width direction. In such a positioning state, the guide hole 48 of the cover portion 44 extends in the axial direction of the instrument main body 12 on the center of the optical portion 38 of the intraocular lens 32 placed on the placement surfaces 41 and 41. Positioned.

  Then, with the cover portion 44 covering the opening 36, the pressing plate connecting portion 60 is bent and the protruding plate portion 64 is inserted into the guide hole 48 of the cover portion 44 from above, and the pedestal portion 62 is covered with the cover portion 44. The protruding plate portion 64 is pushed inward of the instrument body 12 until it is locked. As a result, as shown in FIG. 5B, the protruding tip portion of the protruding plate portion 64 is brought into contact with the optical portion 38 of the intraocular lens 32 and the intraocular lens 32 is bent upwardly. It is deformed and pushed into the plunger insertion hole 42. Here, in the present embodiment, the guide hole 48 is disposed so as to extend upward on the center of the intraocular lens 32, and the protruding plate portion 64 is in a state where the opening portion 36 is covered with the cover portion 44. Is inserted into the guide hole 48 from above, so that the protruding plate portion 64 can be brought into contact with the intraocular lens 32 from above and stable bending deformation can be performed. As described above, in the present embodiment, a guide unit that includes the guide hole 48 and the guide wall portions 110 and 110 and guides the protruding plate portion 64 from above the intraocular lens 32 is configured. Further, since both the cover portion 44 and the pressing plate member 58 are transparent, the protruding plate portion 64 can be pressed while checking the state of the intraocular lens 32. Further, the guide hole 48 has a slightly wide width at the upper opening end portion, so that the protruding plate portion 64 can be easily inserted.

  In the present embodiment, the guide hole 48 is formed to have a size that allows the guide hole 48 to slide and come into contact with the protruding plate portion 64 slightly, so that the restoring force and friction of the guide hole 48 exerted on the protruding plate portion 64 are increased. The pushing-in state of the protruding plate portion 64 is held by force or the like. As described above, in the present embodiment, a holding unit that includes the wall surface of the guide hole 48 and the wall surface of the protruding plate portion 64 and prevents the pressing plate member 58 from easily coming out of the cover portion 44 is configured.

  Then, with the intraocular lens 32 bent as described above, the plunger 14 is pushed toward the distal direction, so that the distal end portion 82 of the plunger 14 is brought into contact with the optical portion 38 of the intraocular lens 32. . Here, in this embodiment, since the tip end portion 82 of the plunger 14 has a semicircular cross section, the tip end portion 82 is between the protruding plate portion 64 and the plunger insertion hole 42, that is, the protruding plate portion 64. It is made to contact | abut to the intraocular lens 32, without contacting the protrusion board part 64 through the lower side. Thereby, the intraocular lens 32 can be pushed into the nozzle 20 in a state where the deformation state by the protruding plate portion 64 is effectively maintained. Further, since the support portions 46 and 46 of the intraocular lens 32 are displaced upward by the bending deformation by the protruding plate portion 64, it is possible to effectively prevent the distal end portion 82 of the plunger 14 from coming into contact with the support portions 46 and 46. Therefore, the possibility of damaging the support portions 46, 46 is also reduced.

  Then, the intraocular lens 32 pushed into the through hole 22 of the nozzle 20 in the deformed state is gradually deformed by the through hole 22 toward the distal end side. In this embodiment, since the flat upper and lower flat surfaces 25 and 26 are formed in the through hole 22 over the entire length, rotation of the intraocular lens 32 in the circumferential direction of the through hole 22 is prevented. Since the left and right wall surfaces 28, 30 and the upper and lower flat surfaces 25, 26 are smoothly connected, even if the intraocular lens 32 is rotated in the circumferential direction of the through-hole 22, it is locally applied to the intraocular lens 32. The possibility of unexpected deformation and breakage of the intraocular lens 32 is reduced by avoiding that a large force is exerted.

  Furthermore, in this embodiment, since the inclined portion 84 is formed in the plunger 14, when the plunger 14 is pushed in, the inclined portion 84 displaces the protruding plate portion 64 upward and pushes it out from the plunger insertion hole 42. Thus, the plunger 14 can be pushed in smoothly. At the same time, a downward force is applied to the plunger 14 by the reaction exerted on the plunger 14 when the protruding plate portion 64 is pushed out, so that the tip 82 is stably positioned on the bottom surface side of the through hole 22. Thus, the intraocular lens 32 can be stably pushed out within the nozzle 20. In this way, the intraocular lens 32 that has moved the nozzle portion 20 is deformed to a smaller extent by the through hole 22, and then is pushed out of the insertion instrument 10 from the tip opening 24 of the through hole 22, Inserted into the eye.

  In the insertion instrument 10 having such a structure, since the placement surfaces 41 and 41 on which the intraocular lens 32 is placed are flat surfaces that do not deform, the intraocular lens 32 can be easily formed. Can be placed. Then, with the intraocular lens 32 placed, the opening part 36 is covered with the cover part 44, so that the intraocular lens 32 can be effectively prevented from falling off.

  Since the protruding plate portion 64 is pressed while preventing the intraocular lens 32 from falling off, the initial deformation can be easily applied to the intraocular lens 32. Further, since the protruding plate portion 64 is guided by the guide hole 48 formed in the cover portion 44 and pressed from above against the center of the intraocular lens 32, the intraocular lens 32 is not rotated. It becomes possible to deform stably.

  In addition, in the insertion instrument 10 according to the present embodiment, the distal end portion 82 of the plunger 14 is brought into contact with the intraocular lens 32 in a non-contact state with the protruding plate portion 64, so that the intraocular lens 32 by the protruding plate portion 64. It is possible to push into the nozzle portion 20 while maintaining the initial deformation state. And after pushing the intraocular lens 32 into the nozzle part 20, the back part from the inclination part 84 of the plunger 14 is formed thickly by pushing out the protrusion board part 64 from the plunger insertion hole 42 by the inclination part 84. And the bending of the plunger 14 can be prevented. At the same time, it is possible to exert a force toward the lower side of the plunger insertion hole 42 with respect to the plunger 14 by a reaction when the protruding plate portion 64 is pushed out. As a result, the distal end portion 82 can be stably positioned below the plunger insertion hole 42, the possibility of pinching the support portion 46 of the intraocular lens 38 can be reduced, and the contact state with the intraocular lens 38 can be reduced. It is also possible to perform stable extrusion while maintaining the above effective.

  As mentioned above, although one Embodiment of this invention was explained in full detail, this is an illustration to the last, Comprising: This invention is not limited at all by the specific description in this Embodiment.

  For example, the cover portion 44 and the pressing plate member 58 are preferably integrally formed with the instrument body 12, but need not be integrally formed. For example, the cover portion 44 and the pressing plate member 58 may be Alternatively, the main body 12 and the main body 12 may be separated from each other.

  Further, the specific shape of the through hole 22 is not particularly limited. For example, the arc shape in the cross section in the extending direction of the through hole 22 of the upper flat surface 25 in the above-described embodiment does not have a constant curvature over the entire length of the through hole 22, and the curvature is different in the middle of the length direction. You may make it. Further, as widely used in conventionally known insertion devices, the nozzle portion 20 may be formed in a simple circular tube shape or the like.

  In the above-described embodiment, the intraocular lens having the shape including the leg-shaped support part 46 extending from the optical part 38 is illustrated as the intraocular lens 32. However, the intraocular lens insertion device according to the present invention is exemplified. Can be applied to, for example, an intraocular lens having a plate-like support member that has been widely used conventionally.

  In addition, although not enumerated one by one, the present invention can be carried out in a mode to which various changes, modifications, improvements and the like are added based on the knowledge of those skilled in the art. It goes without saying that all are included in the scope of the present invention without departing from the spirit of the present invention.

The perspective view which shows the insertion instrument of the intraocular lens as one Embodiment of this invention. The principal part enlarged top view of the insertion instrument. AA thru | or JJ sectional drawing in FIG. The longitudinal cross-sectional explanatory drawing for demonstrating the shape of a through-hole. (A) is sectional explanatory drawing equivalent to the VV cross section in FIG. 1, (b) is sectional explanatory drawing which shows the state which closed the cover part 44 in (a). Side surface explanatory drawing for demonstrating the shape of an extrusion member. Cross-sectional explanatory drawing for demonstrating an advance / retreat prevention mechanism. The perspective view which shows the state which closed the cover main-body part.

Explanation of symbols

10: Insertion instrument, 12: Instrument body, 14: Plunger, 16: Main body cylinder part, 20: Nozzle part, 22: Through hole, 23: Base end opening part, 24: Front end opening part, 25: Upper flat surface, 26 : Lower flat surface, 28: left wall surface, 30: right wall surface, 32: intraocular lens, 34: placement portion, 36: opening portion, 41: placement surface, 42: plunger insertion hole, 44: cover portion, 48 : Guide hole, 50: cover connecting part, 58: pressing plate member, 60: pressing plate connecting part, 64: protruding plate part, 84: inclined part

Claims (8)

The intraocular lens housed in the instrument main body having a substantially cylindrical shape is deformed to a small extent while being moved forward in the axial direction by the pushing member inserted from the rear in the axial direction into the instrument main body, and the distal end in the axial direction of the instrument main body In an intraocular lens insertion device that is inserted into the eye by pushing through an insertion tube provided in the part,
A stage having a substantially flat mounting surface that is opened upward and on which the intraocular lens is mounted is formed at a substantially central portion in the axial direction of the instrument body, and the center in the width direction of the mounting surface A concave groove that extends in the axial direction of the instrument body and opens upward is formed in the part and communicated with the insertion tube part, while being overlapped with the stage to cover the opening of the stage And a lid member having a pressing protrusion for pressing the intraocular lens into the concave groove in a deformed state by being pressed from above onto the intraocular lens placed on the placement surface. In addition, the pressing member having the pressing protrusion is connected to the lid main body portion of the lid member by a flexible second connecting portion and is integrally formed with the lid main body portion. The pressing projection is placed on the mounting surface. Intraocular lens insertion tool, characterized in that guide means are provided which guide is toward the spectacle the lens from above of the intraocular lens. The intraocular lens housed in the instrument main body having a substantially cylindrical shape is deformed to a small extent while being moved forward in the axial direction by the pushing member inserted from the rear in the axial direction into the instrument main body, and the distal end in the axial direction of the instrument main body In an intraocular lens insertion device that is inserted into the eye by pushing through an insertion tube provided in the part,
A stage having a substantially flat mounting surface that is opened upward and on which the intraocular lens is mounted is formed at a substantially central portion in the axial direction of the instrument body, and the center in the width direction of the mounting surface A concave groove that extends in the axial direction of the instrument body and opens upward is formed in the part and communicated with the insertion tube part, while being overlapped with the stage to cover the opening of the stage And a lid member having a pressing protrusion for pressing the intraocular lens into the concave groove in a deformed state by being pressed from above onto the intraocular lens placed on the placement surface. In addition, an insertion device for an intraocular lens, wherein the push-out member is provided with a push-out guide portion that guides the push-down member pressed against the intraocular lens in a direction away from the intraocular lens. Intraocular lens insertion tool according connected by first connection portion of the flexible the instrument body and claim 1 or 2 are integrally molded to the lid member is the instrument body. The lid main body is laterally connected to the instrument main body by the first connecting part, and is overlapped with the stage by folding the lid main body in an open state to the instrument main body side. The intraocular lens insertion device according to claim 3 configured as described above. The intraocular lens insertion device according to claim 1 or 4 , wherein the lid body is provided with holding means for holding the pressing protrusion in a state of pressing the pressing protrusion against the intraocular lens. Intraocular lens insertion tool according to the pressing member the lid body portion and the tool according to claim 1 or 4-5 nearly is connected in the same direction as the axial direction of the body relative. The intraocular lens according to any one of claims 1 to 6 , wherein the pressing protrusion is formed with a dimension extending over an optical part and a support part of the intraocular lens placed on the placement surface. Insertion instrument. The distal end portion of the pushing member is formed with a substantially semicircular cross-sectional shape having a flat surface, and the distal end portion is positioned above the pressing projection in the concave groove by positioning the flat surface upward. The intraocular lens insertion device according to any one of claims 1 to 7 , wherein the intraocular lens insertion device is adapted to be displaced.

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